May 24 , 2002
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Neuroendocrinology Letters incl. Psychoneuroimmunology & Chronobiology

including Psychoneuroimmunology, Neuro
Reproductive Medicine, Chronobiology
and Human Ethology
ISSN 0172–780X

NEL Vol.23 No.2, April 2002

"Non-Seasonal Depression
and BLT "

2002; 23:109-113
pii: NEL220601A04

full text pdf [504 kb]

Bright Light Therapy and/or Imipramine for Inpatients with Recurrent Non-Seasonal Depression

Abstract | Introduction | Subject and Method | Results
Discussion | References

Jan Prasko, Jiri Horacek, Jan Klaschka, Jirina Kosova,
Ivana Ondrackova & Jiri Sipek

Head of the Psychiatric Centre Prague: Prof. MUDr. Cyril Höschl, DrSc.
Psychiatric centre Prague, Ustavni 91, Prague - 8, 181 03 Czech Republic
3rd Medical faculty Charles University Prague, Centre of Neuropsychiatric Studies

Submitted: January 19, 2002
Accepted: January 23, 2002

Key words:
Major depressive disorder, inpatients, bright light therapy, imipramine, combination, clinical trial


INTRODUCTION: The aim of a double-blind study was to assess the efficacy of bright light therapy and/or imipramine in the treatment of inpatients suffering with recurrent non-seasonal major depressive disorder.

METHOD: 34 in-patients with DSM-III-R diagnosis of major depressive disorder, recurrent type, were randomly allocated into 3 treatment groups. After 4-day washout period with baseline assessment they underwent 3 weeks of different types of treatment:
a) Group A: bright light therapy (5000 lux from 6-8 a.m.) and imipramine 150 mg/day.
b) Group B: bright light therapy (5000 lux from 6-8 a.m.) and imipramine-like placebo.
c) Group C: dim red light (500 lux from 6-8 a.m.) and imipramine 150 mg/day.
Outcome measures included weekly Hamilton Psychiatric Rating Scale for Depression, Clinical Global Impression Scale, Montgomery and Asberg Psychiatric Rating Scale for Depression and Beck Depression Inventory.

RESULTS: Patients of all three groups improved significantly. The improvement of the patients of group B treated with bright light therapy plus placebo was superior to the other two groups, but not significantly.

CONCLUSION: Bright light therapy can be effective in the treatment of non-seasonal major depressive disorder.


Depression is a common disorder, with serious consequences for a high proportion of patients. Indeed, it is estimated that 2.6 - 6.2% of the general population experience depression in any given year [1] and that 15% of those who develop severe and recurrent illness eventually take their own lives [2]. Unfortunately, although ranges of effective antidepressant agents are available, many require an administration period of at least 2 weeks, and some up to 4 weeks, before a therapeutic effect is seen [3]. Bright light is a unique treatment method, which is effective and well tolerated and has an early onset of action, in the treatment of patients with Seasonal affective disorder [4, 5]. Some studies reported an antidepressant effect of bright light also in non-seasonal depression (non-SAD) [6, 7, 8]. However, the reports concerning the effect of a short-term administration of bright light on non-SAD depression are controversial. The aim of our double-blind study was to compare the effect of a three week bright light therapy and/or imipramine in the treatment of inpatients suffering with recurrent non-seasonal major depressive disorder.

Subject and Methods
The inclusion criteria ... ...
Exclusion criteria: ... ...
Light specifications: ... ...
Main outcome measures: ... ...
Statistical analysis: ... ...

... ...

... ...

Supported by grant CNS LN00B12 MSMT CR and by grant IGA: 870-2.



1 Angst J. Epidemiology of depression. Psychopharmacol 1992; 102:S71-S74.
2 Montgomery SA. Suicide and antidepressants. Drugs 1992; 43(suppl 2):24-31.
3 Speight TM, Holford NHG, editors. Avery´s Drug Treatment, (4th edn). Adis International Ltd, New Zealand; 1997.
4 Rosenthal NE, Sack DA, Gillin JC et al: Seasonal affective disorder: A description of the syndrome and preliminary findings with light therapy. Arch Gen Psychiatry 1984; 41:72-80.
5 Terman M, Terman JS, Quitkin F, McGrath P, Stewart J, Rafferty B. Light therapy for seasonal affective disorder: A review of efficacy. Neuropsychopharmacology 1989; 2:1-22.
6 Dietzel M, Saletu B, Lesch O, Sieghart W, Schjerve M. Light treatment in depressive illness: Polysomnographic, psychometric, and neuroendocrinologic findings. Eur Neurol 1986; 25(suppl):93-103.
7 Prasko J. Fototerapie a cirkadianni rytmy u depresivnich poruch (dissertation) (Phototherapy and circadian rhythms in depressive disorders.) (In Czech with English abstract): Prague, Charles University; 1991.
8 Kripke D, Mullaney D, Klauber M, Risch S, Gillin C. Controlled trial of bright light for nonseasonal major depresive disorders. Biol Psychiatry 1992; 31:119-134.
9 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Third Edition-Revised. Washington, DS; 1987.
10 Hamilton M. Development of a Rating Scale for Primary Depressive Illness. Brit J Soc Clin Psychol 1967; 6:278-296.
11 Guy W (Ed.). ECDEU Assessment Manual for Psychopharmacology revised Maryland: National Institute of Mental Health; 1976.
12 Montgomery SA, Åsberg M. A New Depression Scale Designed to be Sensitive to Change. Brit. J. Psychiatry 1979; 134:382-389.
13 Beck AT, Beamesderfer A. Assessment of Depression: The Depression Inventory. In: Psychological Measurements in Psychopharmacology 1974; 7:151-169.
14 Filip V, David I, Jirak R, Posmurova M. Prakticky manual psychiatrickych posuzovacich stupnic (Comprehensive manual of psychiatric rating scales). VUPs, Prague 1985.
15 Dixon WJ, editor. BMDP Statistical Software Manual. Version 7,0. Berkeley: University of California Press. Willey & Sons Ltd; 1992.
16 Eastman C. What the placebo literature can tell us about phototherapy for SAD. Psychopharmacol Bull 1990; 26:495-504.


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